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I understand that the fumes from the adhesive using for Eyelash Extensions may cause my eyes to tear up if I open my eyes and some risks of this procedure may be but not limited to eye redness and irritation. I have been informed of potentially harmful or negative side effects that may be caused by the application and/or removal of Eyelash Extensions.

I agree to disclose any allergies that I may have to latex, surgical tapes, cyanoacrylate, Vaseline, ext. to the staff of Alyssa’s Eyelash, Inc. before receiving any services of eyelash extensions.

In signing in below, I agree that by reading and signing in this consent form, I release Alyssa’s Eyelash, Inc. and its owner, officers, or employees from any claims or damages for any nature. I am of sound mind and fully capable of executing this waiver for myself.